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Relationship of Maternal Knowledge of Anemia with Maternal and Child Anemia and Health-Related Behaviors Targeted at Anemia Among Families in Indonesia

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Abstract

Our specific aim was to characterize maternal knowledge of anemia and its relationship to maternal and child anemia and to behaviors related to anemia reduction. We examined the relationship between maternal knowledge of anemia and anemia in the mother and the youngest child, aged 6–59 months, in 7,913 families from urban slums and 37,874 families from rural areas of Indonesia. Knowledge of anemia was defined based upon the mother’s ability to correctly name at least one symptom of anemia and at least one treatment or strategy for reducing anemia. Hemoglobin was measured in both the mother and the child. In urban and rural areas, respectively, 35.8 and 36.9% of mothers had knowledge of anemia, 28.7 and 25.1% of mothers were anemic (hemoglobin <12 g/dL), and 62.3 and 54.0% of children were anemic (hemoglobin <11 g/dL). Maternal knowledge of anemia was associated with child anemia in urban and rural areas, respectively (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.79, 1.02, P = 0.10; OR 0.93, 95% CI 0.87, 0.98, P = 0.01) in multivariate logistic regression models adjusting for potential confounders. There was no significant association between maternal knowledge of anemia and maternal anemia. Maternal knowledge of anemia was significantly associated with iron supplementation during pregnancy and child consumption of fortified milk. There was no association of maternal knowledge of anemia with child deworming. Maternal knowledge of anemia is associated with lower odds of anemia in children and with some health behaviors related to reducing anemia.

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References

  1. de Benoist, B., McLean, E., Egli, I., Cogswell, M. (Eds). (2008). Worldwide prevalence of anaemia 1993–2005. Geneva: World Health Organization. Available at: whqlibdoc.who.int/publications/2008/9789241596657_eng.pdf.

  2. World Health Organization. (2001). Iron deficiency anaemia: Assessment, prevention, and control. A guide for programme managers. Geneva: World Health Organization (WHO/NHD/01.3).

  3. UNICEF/UNU/WHO/MI. (1998). Preventing iron deficiency in women and children. Technical consensus on key issues. UNICEF/UNU/WHO/MI technical workshop, October 7–9, 1998. Boston and Ottawa: International Nutrition Foundation and the Micronutrient Initiative.

  4. Walter, T., Kovalskys, J., & Stekel, A. (1983). Effect of mild iron deficiency on infant mental development scores. Journal of Pediatrics, 102, 519–522.

    Article  PubMed  CAS  Google Scholar 

  5. Walter, T., De Andraca, I., Chadud, P., & Perales, C. G. (1989). Iron deficiency anemia: Adverse effects on infant psychomotor development. Pediatrics, 84, 7–17.

    PubMed  CAS  Google Scholar 

  6. Dallman, P. R. (1974). Tissue effects of iron deficiency. In A. Jacobs & M. Worwood (Eds.), Iron in biochemistry and medicine. London: Academic Press.

    Google Scholar 

  7. Allen, L. H. (1997). Pregnancy and iron deficiency: Unresolved issues. Nutrition Reviews, 55, 91–101.

    Article  PubMed  CAS  Google Scholar 

  8. Bothwell, T. H., Charlton, R. W., Cook, J. D., et al. (1979). Iron metabolism in man. Oxford: Blackwell Scientific.

    Google Scholar 

  9. Galloway, R., Dusch, E., Elder, L., et al. (2002). Women’s perceptions of iron deficiency and anemia prevention and control in eight developing countries. Social Science and Medicine, 55, 529–544.

    Article  PubMed  Google Scholar 

  10. Atmarita. (2005). Nutrition problems in Indonesia. An integrated and international seminar and workshop on lifestyle. Yogyakarta: Gadja Mada University.

  11. Gillespie, S., Kevany, J., & Mason, J. (1991). Controlling iron deficiency. United Nations Administrative Committee on Coordination/Sub-Committee on Nutrition, State-of-the-Art Series Nutrition Policy Discussion Paper 9. Geneva: World Health Organization.

  12. Galloway, R., & McGuire, J. (1994). Determinants of compliance with iron supplementation: Supplies, side effects, or psychology? Social Science and Medicine, 39, 381–390.

    Article  PubMed  CAS  Google Scholar 

  13. Yip, R. (1996). Iron supplementation during pregnancy: Is it effective? American Journal of Clinical Nutrition, 63, 853–855.

    PubMed  CAS  Google Scholar 

  14. Bilenko, N., Yehiel, M., Inbar, Y., et al. (2007). The association between anemia in infants, and maternal knowledge and adherence to iron supplementation in southern Israel. The Israel Medical Association Journal, 9, 521–524.

    PubMed  Google Scholar 

  15. Neumann, C. G., Harris, D. M., & Rogers, L. M. (2002). Contribution of animal source foods in improving diet quality and function in children in the developing world. Nutrition Research, 22, 193–220.

    Article  CAS  Google Scholar 

  16. Neumann, C. G., Bwibo, N. O., & Sigman, M. (1992). Diet quantity and quality: Functional effects on rural Kenyan families. Kenya project final report phase II—1989–1992. Human Nutrition Collaborative Research Support Program, USAID, University of California, Los Angeles.

  17. Neumann, C. G., & Harrison, G. (1994). Onset and evolution of stunting in infants and children. Examples from the Human Nutrition Collaborative Research Support Program, Kenya and Egypt studies. European Journal of Clinical Nutrition, 48, S90–S102.

    PubMed  Google Scholar 

  18. Semba, R. D., Moench-Pfanner, R., Sun, K., et al. (2010). Iron-fortified milk and noodle consumption is associated with lower risk of anemia among children aged 6–59 mo in Indonesia. American Journal of Clinical Nutrition, 92, 170–176.

    Article  PubMed  CAS  Google Scholar 

  19. Stolzfus, R., Albonico, M., Chwaya, H. M., et al. (1998). Effects of the Zanzibar school-based deworming program on iron status of children. American Journal of Clinical Nutrition, 68, 179–186.

    Google Scholar 

  20. Bloem, M. W., Moench-Pfanner, R., & Panagides, D. (Eds.). (2003). Health & nutritional surveillance for development. Singapore: Helen Keller Worldwide.

    Google Scholar 

  21. United Nations Children’s Fund (UNICEF). (2009). The state of the world’s children 2010: Celebrating 20 years of the convention on the rights of the child. New York: UNICEF.

    Google Scholar 

  22. de Pee, S., & Bloem, M. W. (2001). Assessing and communicating impact of nutrition and health programs. In R. D. Semba & M. W. Bloem (Eds.), Nutrition and health in developing countries (pp. 483–506). Totowa, NJ: Humana Press.

    Chapter  Google Scholar 

  23. Bank of Canada. Exchange rates: monthly average rates: 10-year look-up. Available at: http://www.bankofcanada.ca/en/rates/exchange-avg.html. Accessed December 18, 2005.

  24. World Medical Association. (2001). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. Bulletin of the World Health Organization, 79, 373–374.

    Google Scholar 

  25. de Pee, S., Bloem, M. W., Sari, M., Kiess, L., Yip, R., & Kosen, S. (2002). High prevalence of low hemoglobin concentration among Indonesian infants aged 3–5 months is related to maternal anemia. Journal of Nutrition, 132, 2115–2221.

    Google Scholar 

  26. Semba, R. D., de Pee, S., Sun, K., et al. (2008). Paternal smoking and increased risk of infant and under-5 child mortality in Indonesia. American Journal of Public Health, 98, 1824–1826.

    Article  PubMed  Google Scholar 

  27. Semba, R. D., Campbell, A. A., Sun, K., et al. (2001). Paternal smoking is associated with greater food insecurity among poor families in rural Indonesia. Asia Pacific Journal of Clinical Nutrition, 20, 618–623.

    Google Scholar 

  28. Best, C. M., Sun, K., de Pee, S., et al. (2007). Paternal smoking and increased risk of child malnutrition among families in rural Indonesia. Tobacco Control, 17, 38–45.

    Article  Google Scholar 

  29. Zlotkin, S., Arthur, P., Antwi, K. Y., et al. (2001). Treatment of anemia with microencapsulated ferrous fumarate plus ascorbic acid supplied as sprinkles to complementary (weaning) foods. American Journal of Clinical Nutrition, 74, 791–795.

    PubMed  CAS  Google Scholar 

  30. Zlotkin, S., Schauer, C., Christofides, A., et al. (2005). Micronutrient sprinkles to control childhood anemia. PLoS Medicine, 2, 24–28.

    Article  CAS  Google Scholar 

  31. Kodyat, B., Kosen, S., & de Pee, S. (1998). Iron deficiency in Indonesia: Current situation and intervention. Nutrition Research, 18, 1953–1963.

    Article  CAS  Google Scholar 

  32. Mora, J. (2002). Iron supplementation: Overcoming technical and practical barriers. Journal of Nutrition, 132, 853–855.

    Google Scholar 

  33. Olivares, M., Walter, T., Hertrampf, E., Pizarro, F., & Stekel, A. (1989). Prevention of iron deficiency by milk fortification. The Chilean experience. Acta Paediatrica Scandinavica. Supplement, 361, 109–113.

    PubMed  CAS  Google Scholar 

  34. Torrejón, C. S., Castillo-Durán, C., Hertrampf, E. D., & Ruz, M. (2004). Zinc and iron nutrition in Chilean children fed fortified milk provided by the Complementary National Food Program. Nutrition, 20, 177–180.

    Article  PubMed  Google Scholar 

  35. Stekel, A., Olivares, M., Pizarro, F., et al. (1986). Absorption of fortification iron from milk formulas in infants. American Journal of Clinical Nutrition, 43, 917–922.

    PubMed  CAS  Google Scholar 

  36. Hotz, C., & Gibson, R. (2007). Traditional food-processing and preparation practices to enhance bioavailability of micronutrients in plant-based diets. Journal of Nutrition, 137, 1097–1110.

    PubMed  CAS  Google Scholar 

  37. Gibson, R. S., Yeudall, F., Drost, N., et al. (2003). Experiences of a community-based dietary intervention to enhance micronutrient adequacy of diets low in animal source foods and high in phytate: A case study in rural Malawian children. Journal of Nutrition, 133(Suppl 2), 3992S–3999S.

    PubMed  CAS  Google Scholar 

  38. The World Bank. (2011). Appendix A. Examples of nutrition CBC projects that had measurable impact. http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTHEALTHNUTRITIONANDPOPULATION/EXTNUTRITION/0,,contentMDK:20205536~menuPK:282580~pagePK:148956~piPK:216618~theSitePK:282575,00.html. Accessed December 15, 2011.

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Authors and Affiliations

  1. Department of Ophthalmology, Johns Hopkins University School of Medicine, 400 N. Broadway, M015, Baltimore, MD, 21287, USA

    Ellie S. Souganidis, Kai Sun & Richard D. Semba

  2. Nutrition Service, Policy, Strategy and Programme Support Division, World Food Programme, Rome, Italy

    Saskia de Pee & Martin W. Bloem

  3. Sight and Life, Basel, Switzerland

    Klaus Kraemer & Jee-Hyun Rah

  4. Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland

    Regina Moench-Pfanner

  5. Helen Keller International, New York, NY, USA

    Mayang Sari

Authors
  1. Ellie S. Souganidis
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  2. Kai Sun
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  3. Saskia de Pee
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  4. Klaus Kraemer
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  6. Regina Moench-Pfanner
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  9. Richard D. Semba
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Correspondence to Richard D. Semba.

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Souganidis, E.S., Sun, K., de Pee, S. et al. Relationship of Maternal Knowledge of Anemia with Maternal and Child Anemia and Health-Related Behaviors Targeted at Anemia Among Families in Indonesia. Matern Child Health J 16, 1913–1925 (2012). https://doi.org/10.1007/s10995-011-0938-y

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  • DOI: https://doi.org/10.1007/s10995-011-0938-y

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